ST-587 (R-09/14)

This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is required. Failure to provide information may result in this form not being processed and may result in a penalty.

Illinois Department of Revenue

ST-587 Equipment Exemption CertificateStep 1: Identify the seller

The seller must keep this certificate.

Name _______________________________________________ Address _______________________________________________Number and street

Phone (_______)______________________________________ _____________________________________________________ City State ZIP

Step 2: Identify the purchaser (lessor)

Name _______________________________________________ Phone (_______)______________________________________

Address _____________________________________________ Date of purchase ___ ___/___ ___/___ ___ ___ ___Number and street Month Day Year

___________________________________________________ Write the purchaser's Illinois account ID number, FEIN or SSN.City State ZIP Illinois account ID number ______________________________

FEIN ___________________ SSN ___________________

Step 3: Identify the lessee

Name _______________________________________________ Address _______________________________________________Number and street

Phone (_______)______________________________________ _____________________________________________________ City State ZIP

Step 4: Identify the equipment* you are purchasing (or leasing)

* Equipment includes machinery and repair/replacement parts

Type of equipment _______________________________________________________________________________________________

Serial no. _______________________________________________________________________________________________________

Step 5: Identify how you will use this equipment. Check the appropriate box. See instructions.

I state that this equipment will be used

primarily in the manufacturing or assembling of tangible personal property for wholesale or retail sale or lease.primarily in production agriculture.primarily for coal and aggregate exploration and related mining, off-highway hauling, processing, maintenance, and reclamation, but excluding motor vehicles required to be registered under the Illinois Vehicle Code.

Step 6: Blanket Certificate Check the appropriate box in each section.

I am the identified purchaser, and I certify that

all of the purchases that I make from this seller are eligible for the production agriculture exemption. the following percentage, ______ %, of all of the purchases that I make from this seller are eligible for the production agriculture exemption. all of the purchases that I make from this seller are eligible for the coal and aggregate mining exemption. the following percentage, ______ %, of all of the purchases that I make from this seller are eligible for the coal and aggregate mining exemption.

Step 7: Sign below

Under penalties of perjury, I state that I have examined this certificate and, to the best of my knowledge, it is true, correct, and complete.

_______________________________________________________________________________________ __ __/__ __/__ __ __ __Purchaser’s signature Date

You may photocopy this form or you may obtain additional forms by visiting our website at tax.illinois.gov.